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King, Carina, Dube, Albert, Zadutsa, Beatiwel, Banda, Lumbani, Langton, Josephine, Desmond, Nicola 
ORCID: https://orcid.org/0000-0002-2874-8569, Lufesi, Norman, Makwenda, Charles and Hildenwall, Helena
(2021)
'Paediatric Emergency Triage, Assessment and Treatment (ETAT) – preparedness for implementation at primary care facilities in Malawi'. Global Health Action, Vol 14, Issue 1.
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Paediatric Emergency Triage, Assessment and Treatment (ETAT) – preparedness for implementation at primary care facilities in Malawi.pdf - Published Version Available under License Creative Commons Attribution. Download (3MB) | Preview |
Abstract
Background: The majority of deaths amongst children under 5 years are still due to preventable infectious causes. Emergency care has been identified as a key health system weakness, and referrals are often challenging.
Objective: We aimed to establish how prepared frontline facilities in Malawi are to implement WHO Emergency Triage Assessment and Treatment (ETAT) guidelines, to support policy and planning decisions.
Methods: We conducted a concurrent mixed-methods study, including facility audit; healthcare provider survey; focus group discussions (FGD) and semi-structured interviews with facility staff. The study was conducted in two districts in Malawi, Zomba and Mchinji, between
January and May 2019. We included all frontline facilities, including dispensaries, primary health centres, rural and community hospitals. Quantitative data were described using proportions, means and linear regression. Qualitative data was analysed using a framework
approach. Data were analysed separately and then triangulated into common themes.
Results: Forty-seven facilities and 531 healthcare providers were included in the audit and survey; 6 FGDs and 5 interviews were completed. Four common themes emerged: (1) current emergency case management; (2) referral practices; (3) trained staff capacity; (4) opportunities and barriers for ETAT. Triage was conducted in most facilities with various methods described, and 53% reporting all staff are responsible. Referrals were common, but challenging due to
issues in transportation. Twelve percent of survey respondents had ETAT training, with clinical officers (41%) reporting this more frequently than other cadres. Training was associated with increased knowledge, independent of cadre. The main barriers to ETAT implementation were
the lack of resources, but opportunities to improve quality of care were reported.
Conclusions: Malawian frontline facilities are already providing a level of emergency paediatric care, but issues in training, drug supplies and equipment were present. To effectively scale-up ETAT, policies need to include supply chain management, maintenance and strengthening referral communication.
| Item Type: | Article |
|---|---|
| Subjects: | WA Public Health > Health Problems of Special Population Groups > WA 320 Child Welfare. Child Health Services. WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WB Practice of Medicine > WB 105 Emergency medicine. Medical emergencies WS Pediatrics > Diseases of Children and Adolescents > General Diseases > WS 205 Pediatric emergencies |
| Faculty: Department: | Clinical Sciences & International Health > International Public Health Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1080/16549716.2021.1989807 |
| Depositing User: | Rachel Dominguez |
| Date Deposited: | 10 Dec 2021 16:12 |
| Last Modified: | 10 Dec 2021 16:12 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/19593 |
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